Reliability of histologic assessment in patients with eosinophilic oesophagitis

M. J. Warners, C. A. Ambarus, A. J. Bredenoord, J. Verheij, G. Y. Lauwers, J. C. Walsh, D. A. Katzka, S. Nelson, T. van Viegen, G. T. Furuta, Sandeep Gupta, L. Stitt, G. Zou, C. E. Parker, L. M. Shackelton, G. R. D'Haens, W. J. Sandborn, E. S. Dellon, B. G. Feagan, M. H. Collins & 2 others V. Jairath, R. K. Pai

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. Aim: Formally assess the reliability of the EoEHSS and additional histologic features. Methods: Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process. Intra- and inter-rater reliability for scoring the EoEHSS, a visual analogue scale (VAS) of overall histopathologic disease severity, and additional histologic features were assessed using intra-class correlation coefficients (ICCs). Results: Almost perfect intra-rater reliability was observed for the composite EoEHSS scores and the VAS. Inter-rater reliability was also almost perfect for the composite EoEHSS scores and substantial for the VAS. Of the EoEHSS items, eosinophilic inflammation was associated with the highest ICC estimates and consistent with almost perfect intra- and inter-rater reliability. With the exception of dyskeratotic epithelial cells and surface epithelial alteration, ICC estimates for the remaining EoEHSS items were above the benchmarks for substantial intra-rater, and moderate inter-rater reliability. Estimation of peak eosinophil count and number of lamina propria eosinophils were associated with the highest ICC estimates among the exploratory items. Conclusion: The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials.

Original languageEnglish (US)
Pages (from-to)940-950
Number of pages11
JournalAlimentary Pharmacology and Therapeutics
Volume47
Issue number7
DOIs
StatePublished - Apr 1 2018

Fingerprint

Eosinophilic Esophagitis
Visual Analog Scale
Eosinophils
Benchmarking
Mucous Membrane
Epithelial Cells
Clinical Trials
Inflammation
Pathologists
Therapeutics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Warners, M. J., Ambarus, C. A., Bredenoord, A. J., Verheij, J., Lauwers, G. Y., Walsh, J. C., ... Pai, R. K. (2018). Reliability of histologic assessment in patients with eosinophilic oesophagitis. Alimentary Pharmacology and Therapeutics, 47(7), 940-950. https://doi.org/10.1111/apt.14559

Reliability of histologic assessment in patients with eosinophilic oesophagitis. / Warners, M. J.; Ambarus, C. A.; Bredenoord, A. J.; Verheij, J.; Lauwers, G. Y.; Walsh, J. C.; Katzka, D. A.; Nelson, S.; van Viegen, T.; Furuta, G. T.; Gupta, Sandeep; Stitt, L.; Zou, G.; Parker, C. E.; Shackelton, L. M.; D'Haens, G. R.; Sandborn, W. J.; Dellon, E. S.; Feagan, B. G.; Collins, M. H.; Jairath, V.; Pai, R. K.

In: Alimentary Pharmacology and Therapeutics, Vol. 47, No. 7, 01.04.2018, p. 940-950.

Research output: Contribution to journalArticle

Warners, MJ, Ambarus, CA, Bredenoord, AJ, Verheij, J, Lauwers, GY, Walsh, JC, Katzka, DA, Nelson, S, van Viegen, T, Furuta, GT, Gupta, S, Stitt, L, Zou, G, Parker, CE, Shackelton, LM, D'Haens, GR, Sandborn, WJ, Dellon, ES, Feagan, BG, Collins, MH, Jairath, V & Pai, RK 2018, 'Reliability of histologic assessment in patients with eosinophilic oesophagitis', Alimentary Pharmacology and Therapeutics, vol. 47, no. 7, pp. 940-950. https://doi.org/10.1111/apt.14559
Warners MJ, Ambarus CA, Bredenoord AJ, Verheij J, Lauwers GY, Walsh JC et al. Reliability of histologic assessment in patients with eosinophilic oesophagitis. Alimentary Pharmacology and Therapeutics. 2018 Apr 1;47(7):940-950. https://doi.org/10.1111/apt.14559
Warners, M. J. ; Ambarus, C. A. ; Bredenoord, A. J. ; Verheij, J. ; Lauwers, G. Y. ; Walsh, J. C. ; Katzka, D. A. ; Nelson, S. ; van Viegen, T. ; Furuta, G. T. ; Gupta, Sandeep ; Stitt, L. ; Zou, G. ; Parker, C. E. ; Shackelton, L. M. ; D'Haens, G. R. ; Sandborn, W. J. ; Dellon, E. S. ; Feagan, B. G. ; Collins, M. H. ; Jairath, V. ; Pai, R. K. / Reliability of histologic assessment in patients with eosinophilic oesophagitis. In: Alimentary Pharmacology and Therapeutics. 2018 ; Vol. 47, No. 7. pp. 940-950.
@article{8118d4abdda744c092dfd2b3955add5b,
title = "Reliability of histologic assessment in patients with eosinophilic oesophagitis",
abstract = "Background: The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. Aim: Formally assess the reliability of the EoEHSS and additional histologic features. Methods: Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process. Intra- and inter-rater reliability for scoring the EoEHSS, a visual analogue scale (VAS) of overall histopathologic disease severity, and additional histologic features were assessed using intra-class correlation coefficients (ICCs). Results: Almost perfect intra-rater reliability was observed for the composite EoEHSS scores and the VAS. Inter-rater reliability was also almost perfect for the composite EoEHSS scores and substantial for the VAS. Of the EoEHSS items, eosinophilic inflammation was associated with the highest ICC estimates and consistent with almost perfect intra- and inter-rater reliability. With the exception of dyskeratotic epithelial cells and surface epithelial alteration, ICC estimates for the remaining EoEHSS items were above the benchmarks for substantial intra-rater, and moderate inter-rater reliability. Estimation of peak eosinophil count and number of lamina propria eosinophils were associated with the highest ICC estimates among the exploratory items. Conclusion: The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials.",
author = "Warners, {M. J.} and Ambarus, {C. A.} and Bredenoord, {A. J.} and J. Verheij and Lauwers, {G. Y.} and Walsh, {J. C.} and Katzka, {D. A.} and S. Nelson and {van Viegen}, T. and Furuta, {G. T.} and Sandeep Gupta and L. Stitt and G. Zou and Parker, {C. E.} and Shackelton, {L. M.} and D'Haens, {G. R.} and Sandborn, {W. J.} and Dellon, {E. S.} and Feagan, {B. G.} and Collins, {M. H.} and V. Jairath and Pai, {R. K.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1111/apt.14559",
language = "English (US)",
volume = "47",
pages = "940--950",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Reliability of histologic assessment in patients with eosinophilic oesophagitis

AU - Warners, M. J.

AU - Ambarus, C. A.

AU - Bredenoord, A. J.

AU - Verheij, J.

AU - Lauwers, G. Y.

AU - Walsh, J. C.

AU - Katzka, D. A.

AU - Nelson, S.

AU - van Viegen, T.

AU - Furuta, G. T.

AU - Gupta, Sandeep

AU - Stitt, L.

AU - Zou, G.

AU - Parker, C. E.

AU - Shackelton, L. M.

AU - D'Haens, G. R.

AU - Sandborn, W. J.

AU - Dellon, E. S.

AU - Feagan, B. G.

AU - Collins, M. H.

AU - Jairath, V.

AU - Pai, R. K.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. Aim: Formally assess the reliability of the EoEHSS and additional histologic features. Methods: Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process. Intra- and inter-rater reliability for scoring the EoEHSS, a visual analogue scale (VAS) of overall histopathologic disease severity, and additional histologic features were assessed using intra-class correlation coefficients (ICCs). Results: Almost perfect intra-rater reliability was observed for the composite EoEHSS scores and the VAS. Inter-rater reliability was also almost perfect for the composite EoEHSS scores and substantial for the VAS. Of the EoEHSS items, eosinophilic inflammation was associated with the highest ICC estimates and consistent with almost perfect intra- and inter-rater reliability. With the exception of dyskeratotic epithelial cells and surface epithelial alteration, ICC estimates for the remaining EoEHSS items were above the benchmarks for substantial intra-rater, and moderate inter-rater reliability. Estimation of peak eosinophil count and number of lamina propria eosinophils were associated with the highest ICC estimates among the exploratory items. Conclusion: The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials.

AB - Background: The validity of the eosinophilic oesophagitis (EoE) histologic scoring system (EoEHSS) has been demonstrated, but only preliminary reliability data exist. Aim: Formally assess the reliability of the EoEHSS and additional histologic features. Methods: Four expert gastrointestinal pathologists independently reviewed slides from adult patients with EoE (N = 45) twice, in random order, using standardised training materials and scoring conventions for the EoEHSS and additional histologic features agreed upon during a modified Delphi process. Intra- and inter-rater reliability for scoring the EoEHSS, a visual analogue scale (VAS) of overall histopathologic disease severity, and additional histologic features were assessed using intra-class correlation coefficients (ICCs). Results: Almost perfect intra-rater reliability was observed for the composite EoEHSS scores and the VAS. Inter-rater reliability was also almost perfect for the composite EoEHSS scores and substantial for the VAS. Of the EoEHSS items, eosinophilic inflammation was associated with the highest ICC estimates and consistent with almost perfect intra- and inter-rater reliability. With the exception of dyskeratotic epithelial cells and surface epithelial alteration, ICC estimates for the remaining EoEHSS items were above the benchmarks for substantial intra-rater, and moderate inter-rater reliability. Estimation of peak eosinophil count and number of lamina propria eosinophils were associated with the highest ICC estimates among the exploratory items. Conclusion: The composite EoEHSS and most component items are associated with substantial reliability when assessed by central pathologists. Future studies should assess responsiveness of the score to change after a therapeutic intervention to facilitate its use in clinical trials.

UR - http://www.scopus.com/inward/record.url?scp=85042160903&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042160903&partnerID=8YFLogxK

U2 - 10.1111/apt.14559

DO - 10.1111/apt.14559

M3 - Article

VL - 47

SP - 940

EP - 950

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 7

ER -